Year 2024, Volume 14 - Issue 1

No Abstract available.

Background: Nuclear medicine is a specialized field that employs radioisotopes for both diagnostic and therapeutic applications. Technetium-99m (Tc-99m), widely utilized in nuclear imaging, is eluted from a molybdenum generator. During this elution process, molybdenum (Mo) can occasionally contaminate the Tc-99m, compromising image quality and increasing patient radiation dose. The measurement of molybdenum contamination, referred to as the molybdenum breakthrough test (MBT), is critical to ensure safety and compliance with international standards. Aim and Objective: This study aimed to evaluate and report the MBT data collected over 10 years at the Atomic Energy Cancer Hospital, Bannu, to assess adherence to international limits and trends in molybdenum breakthrough. Methods: MBT data were collected from 5th November 2013 to 30th December 2023 using a dose calibrator (CRC-25R) and standard molybdenum canisters for each elution from molybdenum generators. Data were analyzed using standard statistical methods to determine compliance with the internationally recommended limit of 0.15 µCi of 99Mo/mCi of 99mTc. Results: The analysis revealed that molybdenum contamination levels consistently remained below the recommended threshold. The mean MBT value was 0.018 ± 0.023 µCi of 99Mo/mCi of 99mTc, with a standard error of the mean of 0.006%. Conclusion: The findings indicate that the molybdenum breakthrough levels at the institute complied with international safety standards over the studied decade, demonstrating a high standard of quality control in generator elution procedures.

Background: Condylar hyperplasia (CH) is excessive growth of either mandibular condyle leading to facial asymmetry [1]. The aim of this study was to access the condylar growth by 99mTc-MDP SPECT-CT bone scan, and compared the results with age matched control groups. Methods: 57 patients of age 10-30 years were enrolled, 26/57 were diseased with CH and 31/57 belong to control group. Both groups were divided into group A (10-20 years) and group B (21-30years). All underwent 99mTc-MDP SPECT-CT bone scan of head region. The condyle to L4 vertebra ratio on planner and condyle to clivus ratio on summed SPECT images were measured. The mandibular deviation was measured in diseased group on the coronal view of 3D CT reconstruction image of the head. Results: Both SPECT and planner parameters classified 17/26 patients as active CH. The mean condyle to clivus ratio and condyle to L4 vertebra ratio of active condyles is higher than control group, (p =

Objective: Radioisotopes are administered in varying amounts to patients orally and intravenously for treatment and diagnostic procedures in nuclear medicine. It is an established fact that radionuclides have both therapeutic and harmful effects on humans. Hence, the need for individual patient dosimetry is an important factor in optimizing patient-specific doses. The study objective is to estimate the internal radiation doses to the selected patients undergoing Tc99m - MIBI scan using computer codes. Material and Methods: Technetium 99m MIBI was administered to the ten randomly selected patients for the rest study. Whole body planar scintigraphy at a different time was performed on a dual-head gamma camera. SPECT-CT gamma camera is installed in the nuclear medicine department at Nuclear Medicine, Oncology, and Radiotherapy Institute, Islamabad. The injected activity ranged from 821 to 993 MBq. The absorbed and effective doses for all selected patients are measured using OLINDA/EXM version 2.0 and IDAC DOSE VERSION 2.1 computer codes. Results: The obtained results show that this is the highest mean absorbed dose received by kidneys and intestine using Olinda/exm and idac dose, respectively. The mean effective dose for Tc99m-MIBI from Olinda/exm for selected patients was found to be 5.52 µSv/MBq and 6.8 µSv/MBq assessed for idac dose software. The results from both the codes are compared to ICRP 128 publication and show a significant correlation within the recommended limits with ICRP dose guidelines. These results are considered key to greater accuracy in internal dose calculation and very useful for patients, education, and research studies.

Background: Radiation protection is part of a global approach to managing the risks of exposure to ionizing radiation. The objective of this study is to assess the knowledge of workers in an environment at risk of irradiation and to describe the radiation protection measures implemented in services using ionizing radiation. Materials and method: We conducted a cross-sectional study for 3 months from November 22, 2022 to February 22, 2023. It took place in the radiology, nuclear medicine, radiotherapy and orthopedic surgery departments of hospitals in Dakar. Our study population was all workers exposed to ionizing radiation and on the job at the time of the survey. The study instrument was an anonymous self-administered questionnaire whose variables concerned socio-professional data, collective and individual radiation protection measures and patient radiation protection. Data analysis was obtained using EPI Info version 7 software. Results: Out of 160 questionnaires distributed, we collected 97, representing a participation rate of 60.63%. The average age was 36.20 years ± 8.66 (extremes of 23 and 62 years) and the sex ratio was 1.38 in favor of men. The average duration of daily exposure was 6 hours (39.19%) and 81.58% concerned imaging services. The main sources of irradiation was conventional radiography (69.07%) followed by CT scanning (55.67%). In our cohort, 50.52% had knowledge of the regulatory texts on radiation protection and 60.82% were aware of the existence of dosimetric monitoring where they work. The most used personal protective equipment is the lead apron (51.55%), the dosimeter (47.42%) and the thyroid cover (13.40%). Workers respected the regulatory distance from the source in 69.79% but 84.54% were not able to describe the action to be taken in the event of an incident or accident. Conclusion: Workers' knowledge of radiation protection was unsatisfactory and the right attitudes in this area were not always adopted. Strengthening the radiation protection module in the training of this type of personnel is a necessity. The authorities must strengthen radiation protection equipment and ensure compliance with appropriate measures.

Background: Carcinoids are slow-growing neuroendocrine tumors that can be found throughout the gastrointestinal tract and in other organs like the lungs and kidneys. These tumors are capable of metastasis and production of certain chemicals, e.g., serotonin that can cause carcinoid syndrome. Initial treatment is surgery; however, inoperable or metastatic carcinoid tumors can be treated with peptide receptor radionuclide therapy using [177Lu]Lu-DOTA-TATE which can provide symptomatic relief and also slows the disease progression. Case presentation: We present here a case of gastrointestinal carcinoid in a 65-year-old male patient treated with indigenously produced [177Lu]Lu-DOTA-TATE. The patient presented 3 years after the resection of the intestinal mass and was on somatostatin analogues for control of flushing and diarrhea. Investigations revealed a focal lesion in the liver for which [177Lu]Lu-DOTA-TATE therapy was planned. The patient underwent four cycles of [177Lu]Lu-DOTA-TATE therapy with no undesirable side effects. Six months follow-up investigations after the completion of four cycles of [177Lu]Lu-DOTA-TATE therapy showed no interval progression and a better control of symptoms. Conclusion: [177Lu]Lu-DOTA-TATE therapy is an effective but expensive treatment for patients having symptomatic disease and inoperable or progressive neuroendocrine tumors; that do not respond well to conventional treatments. Until recently, [177Lu] Lu-DOTA-TATE had to be imported for use in such patients which increased its cost even more. However, the initiative for the production of this radio-pharmaceutical in Pakistan has made it easier to acquire and also lowered the cost significantly.

A 18F-FDG PET/CT scan was conducted to evaluate the extent of recently diagnosed breast carcinoma in a 59-year-old patient. This was done following inconclusive results from a CT scan and bone scan, primarily due to extensive skin calcinosis complicating dermatomyositis. The PET/CT scan identified abnormal metabolic activity in the right breast and hypermetabolic lymph nodes. Interestingly, no other abnormal metabolic foci were found elsewhere in the body, despite discreetly diffuse hypermetabolic subcutaneous calcifications in the trunk and limbs. This underscores the diagnostic effectiveness of 18F-FDG PET/CT in such challenging cases.